1. Field of the Invention
The present invention generally relates to quality control of Gamma cameras in the area of medical diagnostic imaging. In particular, the present invention relates to systems and methods for troubleshooting and performance testing of detectors and other circuitry in a Gamma camera by adding a pulse injection circuit to the Gamma camera.
2. Description of the Background
Gamma cameras are primarily used by doctors who specialize in the field of nuclear medicine. Nuclear medicine is a unique medical specialty wherein Gamma cameras are used in conjunction with very low-level radioactive materials (called radionuclides or radiopharmaceuticals) to generate images of the anatomy of organs, bones or tissues of the body. Gamma cameras can also generate images that can be used to determine whether an organ is functioning properly.
Radionuclides or radiopharmaceuticals are introduced orally or intravenously into the body of a patient. Radiopharmaceuticals are specially formulated to collect temporarily in a certain part of the body to be studied, such as the patient's heart or brain. Once the radiopharmaceuticals reach the intended organ, they emit Gamma rays that are then detected and measured by the Gamma camera. The basic camera sold commercially for nuclear medical imaging is still similar to the original invention by Anger (U.S. Pat. No. 3,011,057, which is incorporated in its entirety by reference herein).
A Gamma camera includes a large area scintillation crystal, which functions as a Gamma ray detector. The crystal is typically sodium iodide doped with a trace of thallium (NaI(Tl)). The crystal converts high-energy photons (e.g., Gamma rays and X-rays) into visible light (i.e., lower energy photons). The crystal is positioned to receive a portion of the Gamma ray emissions from the radiopharmaceuticals.
When a Gamma ray strikes and is absorbed in the scintillation crystal, the energy of the Gamma ray is converted into flashes of light (i.e., a large number of scintillation photons) that emanate from the point of the Gamma ray's absorption in the scintillation crystal. A photo-multiplier tube (PMT), which is optically coupled to the scintillation crystal, detects a fraction of these scintillation photons and produces an output electronic signal (e.g., current or voltage pulse) having an amplitude that is proportional to the number of detected scintillation photons. The Gamma ray camera typically has several photomultiplier tubes placed in a two dimensional array, with the signals from the different photomultiplier tubes being combined to provide an indication of the positions and energies of detected Gamma rays.
The scintillation photons emitted from the detector crystal are typically in the visible light region of the electromagnetic spectrum (with a mean value of about 3 eV for NaI(Tl)). The scintillation photons spread out from the point of emission. A large fraction of the scintillation photons are transported from the point of emission to a light sensitive surface, called the photocathode, of the PMTs. A fraction of the scintillation photons incident on the photocathodes cause an electron to be emitted from the photocathode.
The electron, also called a photoelectron, is then electrostatically accelerated into an electron multiplying structure of the PMT, which causes an electrical current (or voltage) to be developed at an output of the PMT. The amplitude of the electrical signal is proportional to the number of photoelectrons generated in the PMT during the time period that scintillation photons are being emitted. Thus, after a Gamma ray absorption event, the PMT outputs an electrical signal that can be used with other signals from other PMTs to determine the location of the Gamma ray absorption event.
The number of scintillation photons producing electrical signals in each PMT is inversely related to the distance of the PMT from the point of Gamma ray absorption, or event location. It is because of this relationship that the position of the event can be calculated from the signals of the PMTs surrounding the event location.
Ideally, the signal derived from each PMT should have exactly the same proportional relationship to the distance from the event location as for all other PMTs. The amplitudes of the signals derived from each PMT are proportional to two basic factors: 1) the number of scintillation photons detected by a PMT, and 2) the gain or amplification of the PMT. The accuracy to which the position of the event location can be calculated depends on these two factors remaining constant in time.
Typically, a Gamma camera is tuned prior to its operation so as to ensure that the camera will calculate accurately the positions of event locations anywhere within an area called the field of view (FOV). Commercial, large field of view Gamma cameras have between 50 and 100 PMTs. A tuning procedure will typically require a number of steps that balance or equalize the signal amplitudes of the PMTs. The gains of the PMTs are adjusted such that the sum of the signals from all the PMTs is approximately equal in response to a fixed energy Gamma event, regardless of the location of the event.
A known pattern of event locations are presented to the camera, usually by placing a mask of precisely spaced lines or holes over the camera crystal, so that event location calculations can be calibrated to give the known locations fixed by the positions of the holes or slits, where the Gammas can pass through the mask. The exact tuning and/or calibration steps may be different among cameras produced by different manufacturers. However, once the tuning and calibration steps are complete, the image quality, which is incumbent on the camera's ability to accurately position event locations, depends on the transport of scintillation light to the PMTs and the gains of the PMTs remaining unchanged from the time when the tuning and calibration procedures were performed.
A number of factors can cause a change in either the gain of a PMT or the light collection properties of the camera. PMT gain is a strong function of temperature, counting rate (i.e. the number event signals per unit time), and the high voltage (HV) power supply regulation. Additionally, PMTs change their gain over time as they age. The light collection from the crystal to the photocathodes of the PMTs can change if the transmissive properties of surfaces change. For example, the PMTs are optically coupled to a glass or plastic lightpipe using either an optical grease or epoxy. If any of these materials' light transmission properties change, then the transport of scintillation photons to the PMT will change. Additionally, NaI(Tl) is a hygroscopic material, and if water vapor reaches the crystal it becomes yellow and the light transmission is diminished.
Different manufacturers have developed and implemented different means to maintain the constancy of PMT gains. These means fall into two categories: 1) automatic (i.e. not requiring the user to initiate the process), and 2) user quality control procedures (i.e. procedures initiated by the user). Generally, a combination of both automatic and quality control procedures is required.
One known automatic system, for example, utilizes light emitting diodes (LEDs) coupled into the photomultiplier tubes to provide a light signal for calibration of each individual tube. A constant fraction of the light emitted by the LED is incident on the light sensitive photocathode of the PMT. The PMT output signal is checked against a reference that was set at the time of the last calibration. The gain of the PMT is adjusted if the measured signal has strayed from the reference.
This gain calibration technique depends on the light emitting diodes having a constant light output for each pulse. Light emitting diodes, however, do not have constant light output as a function of temperature, and may also vary over the lifetime of the diode. Another drawback of this technique of automatic calibration is that the light from the diode is mostly directly incident on the photocathode of the photomultiplier tube. Therefore, the transport of the light through the scintillation crystal, and associated optical elements, is not significantly sampled by the pulse of light from the diode.
User initiated quality control procedures usually require the placement of a radioactive source to uniformly illuminate the camera. The system acquires an appropriate number of events to achieve statistically significant sampling of each event location. A computer program then analyzes the measured energies and/or image of event locations to determine whether or not the system has drifted away from the properly calibrated state. Many variations of this procedure are possible, but all require the user to position a source of radioactivity and initiate the computer controlled acquisition and analysis. Additionally, the procedures also typically require the user to remove the collimator from the camera.
Quality control procedures are cumbersome to the user. If they can be initiated at the end of the day, and complete themselves automatically, then the user's time required is minimal. However, radioactive sources that must be left out in a room overnight require institutional procedures for securing the room, logging out the source and returning it in the morning, and prohibiting access to the room by cleaning and unauthorized personnel. Performing quality control procedures during working hours reduces available patient imaging time on the system and increases costs because personnel are not doing patient imaging.
Thus, it is desired to have a more reliable, cost effective means to troubleshoot and performance test any one or all of the detectors of a Gamma camera.